Change to CPAP Machines Claims Administration
Posted on Monday, November 16th, 2020
Effective January 1, 2021, Sun Life will no longer reimburse for CPAP machines in cases of mild obstructive sleep apnea. This change will affect members with newly diagnosed mild sleep apnea as well as existing plan members who choose to purchase a new CPAP machine once their five (5) year frequency limit has expired. Please note, Sun Life will continue to reimburse Continuous Positive Airway Pressure (CPAP) machines for moderate and severe diagnoses.
The Canadian Agency for Drugs and Technologies in Health (CADTH) defines mild sleep apnea as an Apnea-Hypopnea Index (AHI) of under 15. Residents of Ontario, Manitoba and Saskatchewan may be eligible for provincial funding.
Further information can be found through the below links:
https://www.ontario.ca/page/respiratory-equipment-and-supplies
https://www.gov.mb.ca/fs/eia_manual/print,22.html
https://publications.saskatchewan.ca/#/products/87731
If you have any questions regarding this update, please do not hesitate to contact humanresources@algonquincollege.com. Alternatively, you may contact Sun Life at 1-800-361-6212, Monday to Friday, 8 a.m. to 8 p.m. ET.